NANCY M MANTICH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031609

License Status

EXPIRED

Business

First Name

NANCY M

Last Name

MANTICH

Business Name

NANCY M MANTICH

Original Issue Date

06/01/1994

Effective Date

06/01/1994

Expiration Date

06/20/1997

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006